Breast cancer: PET and MR predict chemotherapy's ability to prolong life

Parallel imaging improves risk stratification and patient management and hints toward potential benefits of simultaneous PET/MR

2013-06-11

(Press-News.org) Vancouver, British Columbia – For patients with advanced breast cancer, positron emission tomography (PET) and magnetic resonance (MR) imaging can improve quality of life and survival by providing physicians with information on the effectiveness of chemotherapy prior to surgery, say researchers presenting at the 2013 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging.

Researchers combined separate imaging systems—PET, MR and CT—to map the course of chemotherapy before surgery, otherwise known as neoadjuvant chemotherapy. These different imaging systems provide complementary information, both physiological and structural, about how chemotherapy will be distributed in the body to kill breast cancer and metastatic tumors. In this study, scientists used a specialized molecular imaging agent called F-18 fluorodeoxyglucose (FDG) that acts as a biomarker for cellular metabolism with PET in order to pick up on areas of cancer proliferation.

"Previous studies have shown that, separately, FDG PET and dynamic enhanced MR imaging can provide a prediction of how patients will respond to neoadjuvant treatment, but we have improved upon this concept by combining the two techniques side by side," said Sang Moo Lim, MD, current director of the department of nuclear medicine, and until 2006, director of the National Radiation Emergency Medical Center of the Korea Institute of Radiological and Medical Sciences in Seoul, Korea. "Using both FDG PET and MR imaging to predict cancer progression-free survival allows us to apply more aggressive therapies that could potentially halt patients' cancers and extend their lives."

This study evaluating survival after chemotherapy included a patient population of 44 women with advanced breast cancer. All underwent three cycles of neoadjuvant chemotherapy and sequential whole-body FDG PET/CT, breast MR and delayed breast PET/CT a total of four times—once prior to the first course of chemotherapy, again after the first course, following the second course and one more time prior to surgery to predict and confirm disease-free survival. Results of the study indicated that patient survival with no recurrence of cancer after neoadjuvant chemotherapy was anywhere from just under three months to about three years for a median of 661 days.

"Additionally, this study demonstrates the collective potential of these imaging systems, which provides evidence that fused PET/MR utilizing both metabolic and vascular perfusion imaging can benefit patients," said Lim. "Together these techniques can help clinicians classify patients and provide risk stratification to not only predict cancer recurrence after treatment but also avoid chemotherapy for those who probably would benefit more from an alternative treatment."

This research using combined, sequential PET and MR imaging provides additional proof of the potential benefit of simultaneous PET/MR imaging, an emerging molecular imaging technology.

"This extends beyond just breast cancer," Lim added. "We could potentially apply these technologies to other malignancies and develop some brilliant methods to improve clinical outcomes. Considering the results of our research, we now need to further develop the technology—not just imaging systems, but tracers and biomarkers—to advance our field. Research and development in nuclear medicine and molecular imaging can satisfy these demands for the future."

Breast cancer is the world's leading cancer among women–accounting for 16 percent of cancers in females, according to the World Health Organization. The American Cancer Society estimates that one out of every eight American women will develop invasive breast cancer at some point in their lives. According to 2013 statistics, approximately 232,340 new cases of invasive breast cancer are expected to be diagnosed in women in the United States and as many as 39,620 American women are expected to die from the disease this year.

### Scientific Paper 76: Jihyun Park, Ilhan Lim, Byung Il Kim, Chang Woon Choi, Sang Moo Lim, Nuclear Medicine, Korea Institution Radiological & Medical Science, Seoul, Republic of Korea; Woo Chul Noh, Hyun-Ah Kim, Eun-Kyu Kim, Surgery, Korea Institution Radiological & Medical Science, Seoul, Republic of Korea; Seung Sook Lee, Pathology, Korea Institution Radiological & Medical Science, Seoul, Republic of Korea, "Prediction of the disease free survival in patients with advanced breast cancer after first cycle of neoadjuvant chemotherapy using parallel PET/MR," SNMMI's 60th Annual Meeting, June 8, 2013, Vancouver, British Columbia.

ELSE PRESS RELEASES FROM THIS DATE:

PET/MR effective for imaging recurrent prostate cancer

2013-06-11

Vancouver, British Columbia – When prostate cancer makes a comeback, it becomes increasingly important to have exceptional imaging available to find all possible regions where cancer has spread to other parts of the body, or metastasized, in order to plan the best possible treatment. A relatively new imaging system that simultaneously combines positron emission tomography and magnetic resonance (PET/MR) demonstrates a higher capacity for mapping recurrent prostate cancer than the already high standard of integrated PET and computed tomography (PET/CT), say researchers presenting ...

Hormonal treatment for endometrial cancer does not directly target the malignant cells

2013-06-11

Progesterone, a female hormone that can be used as a therapy for endometrial cancer, eliminates tumor cells indirectly by binding to its receptor in stromal or connective tissue cells residing in the tumor microenvironment, according to a study from the G.O. Discovery Lab team and collaborators at UCLA. Like tumors of the breast and prostate, endometrial cancer is regulated by hormones. Unlike therapies for breast and prostate cancer, where drugs are given to block hormone signaling, in therapy for endometrial cancer progesterone is given to stimulate its hormone receptor. ...

Plunging fish numbers linked to dam releases

2013-06-11

A significant decline in the numbers of native fish in Australia's Murray-Darling Basin may be linked to released dam water being too cold for breeding. This is just one of the findings from a Griffith University led study which found current water releases back into the Murray-Darling system limit fish reproduction and therefore impact freshwater biodiversity. Griffith University Research Fellow Dr Rob Rolls said the results, published in Freshwater Biology, throw cold water on the notion that large dam releases compensate for the effects of interrupting natural water ...

Screening fails to affect breast cancer mortality statistics

2013-06-11

New research analysing breast cancer mortality data spanning almost 40 years concludes that breast cancer screening does not yet show an effect on mortality statistics. The research, published in the Journal of the Royal Society of Medicine, analysed mortality trends before and after the introduction of the National Health Service Breast Screening Programme in 1988. The research was based on an analysis of mortality statistics in the Oxford region because, unlike the rest of England, all causes of death on the death certificate, not just the underlying cause, are available ...

'Popcorn' particle pathways promise better lithium-ion batteries

2013-06-11

LIVERMORE, Calif.— Researchers at Sandia National Laboratories have confirmed the particle-by-particle mechanism by which lithium ions move in and out of electrodes made of lithium iron phosphate (LiFePO4, or LFP), findings that could lead to better performance in lithium-ion batteries in electric vehicles, medical equipment and aircraft. The research is reported in an article entitled, "Intercalation Pathway in Many-Particle LiFePO4 Electrode Revealed by Nanoscale State-of-Charge Mapping" in the journal Nano Letters, 2013, 13 (3), pp 866-872. Authors include Sandia physicist ...

New means to communicate population risk assessments among scientists and decision-makers

2013-06-11

Population viability analysis (PVA) is a method used by conservation scientists for a range of purposes – including advancing conservation theory, planning, policy and management. PVAs are particularly important for assessing the risks of population extinction and for comparing alternative management options to protect species. The fact that so many PVAs are already available, for hundreds of species, offers an exciting opportunity for learning and especially for moving from single-species experience to multi-species knowledge. But this opportunity is often lost in translation: ...

Rice research investment delivers sixfold return

2013-06-11

A US$12 million investment in rice research has returned more than $70 million in benefits to rice farmers and national economies in four Asian countries, according to a new report. The report looked at a selection of natural resource management technologies rolled out by the International Rice Research Institute (IRRI) as part of the Irrigated Rice Research Consortium (IRRC) mandate in Bangladesh, Indonesia, Vietnam, and the Philippines. It aimed to see whether the technologies delivered benefits such as increased productivity for rice farmers, improved livelihoods and ...

Painting by numbers

2013-06-11

The skin colour of humans ranges from pale pinkish-white to very dark brown and relates largely to the amount of melanin produced by specialized cells in the body. The synthesis of melanin is under the influence of a bewildering array of genes, each of which naturally occurs in a variety of different forms or alleles, thus accounting for the wide variety of skin colours found in our species. But how precisely the variation is brought about is still unknown. Nine genes account for pigmentation in the fruit fly Colour also differs, albeit sometimes more subtly, in many ...

New archaeogenetic research refutes earlier findings

2013-06-11

When did modern humans settle in Asia and what route did they take from mankind's African homeland? A University of Huddersfield professor has helped to provide answers to both questions. But he has also had to settle a controversy. Professor Martin Richards, who heads the University's Archaeogenetics Research Group, co-authors a new article in the journal Proceedings of the National Academy of Sciences of the United States of America. It refutes a recent theory, that there is archaeological evidence for the presence of modern humans in southern Asia before the super-eruption ...

Posttraumatic stress disorder treatment: Genetic predictor of response to exposure therapy

2013-06-11

Philadelphia, PA, June 11, 2013 – There is growing evidence that a gene variant that reduces the plasticity of the nervous system also modulates responses to treatments for mood and anxiety disorders. In this case, patients with posttraumatic stress disorder, or PTSD, with a less functional variant of the gene coding for brain-derived neurotrophic factor (BDNF), responded less well to exposure therapy. This gene has been implicated previously in treatment response. Basic science studies have convincingly shown that BDNF levels are an important modifier of the therapeutic ...